We Have No Idea What Donald Trump is Going to Do About Insulin Prices

In the midst of Time Magazine’s 6,000-word “Person of the Year” profile of Donald Trump, the president-elect said, “I’m going to bring down drug prices…I don’t like what has happened with drug prices.”

Those 16 words were enough to make our most recent November 16th coverage on Donald Trump and drug prices (“Trump May Not Take on Insulin Prices After All”) out of date. And that story was written to update a previous story on Mr. Trump’s campaign-trail stance on drug pricing (“Could a President Trump Drive Down Insulin Prices”) that also was outdated. This will be our third attempt to outline Mr. Trump’s position on drug prices, and I have little faith that it will bring any clarity as to what he might actually do once in office.

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Mr. Trump ran on an unabashedly populist platform that won over a sizeable number of voters who are economically anxious. Drug pricing was not the centerpiece of his populist rhetoric, but on the campaign trail he did briefly describe his plans to have Medicare negotiate for better drug prices; he also signaled his intent to remove hurdles to importing cheaper drugs made abroad.

Immediately after winning a majority of votes in the electoral college, however, Mr. Trump’s transition team put out an agenda that made no mention of drug price control policies. Also, his transition team included many pharmaceutical company lobbyists, as well as elected officials who had received substantial donations from drug companies. That seemed to indicate that drug price control was pushed to the background, if not off the table completely.

And now we have this short quote, with no context or hint of a plan provided. As a reporter, it’s my job to relay this quote to you, but as an editor I have to tell you I have no definitive idea what it means.

Based on Mr. Trump’s history, here are the possible scenarios:

1. This is an off-the-cuff remark, one that doesn’t carry much weight.
He might be thinking aloud, but not making any promises. These “throwaway lines” are extremely hard to judge, as Mr. Trump has proven that sometimes seemingly random tweets later are revealed to have a rhyme and reason to them. Political observers have speculated that his past random-seeming statements might have been meant to distract from bigger issues in the news cycle. They also sometimes turn out to be the fruit of lobbying work that has taken months (as with his tweets and statements about Taiwan and China).

2. He’s lying.
Whether you are a supporter or detractor of Mr. Trump, it has to be acknowledged that he sometimes says things that he knows are factually inaccurate. In September, Politico reporters tracked everything Mr. Trump said for a five-day period and found that by the end of the period he had made 87 erroneous statements, or one falsehood every three minutes and 15 seconds of public speaking. Most recently, a union representative speaking of the Carrier deal said Mr. Trump significantly overstated the number of jobs he might have saved by convincing the company not to shift all its production from that U.S. plant to Mexico. Since we do not yet have any legislative track record to see how many of Mr. Trump’s campaign promises he will keep, we have to allow for the possibility that he has no intention of taking action on drug prices.

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3. He’s practicing Twitter-style economic policymaking.
As he gets closer to assuming the presidency, Mr. Trump has taken to becoming a one-man dispenser of what he feels is economic justice by tweeting criticism of other companies. After the Carrier deal, Mr. Trump fired off tweets against another Indiana company, Rexnord, as well as Boeing. He could be using his bully pulpit to prime these businesses for future negotiations.

This might be what he’s doing with drug companies, as well. As the Time profile noted, biotechnology stocks rose nine percent the day after Mr. Trump was elected. He could very well be putting biotech companies on notice that they may, too, find themselves in the crosshairs of his Twitter account, or at least that they should remember who will be in charge come January 20th, 2017.

In my initial profile of Mr. Trump’s stances on drug pricing, I stated that the president-elect would still have to work on drug pricing legislation with Republican lawmakers, who may be hostile to curbing drug prices through government control. The only way he would be successful, and the only way Mr. Trump would get elected in the first place, would be if there were a populist realignment of the political landscape.

The election results show this has happened. What that means, however, is that all bets are off on what happens next when it comes to drug prices. In other words, your guess is as good as mine as to what Mr. Trump will do next.

| June 25th 2016

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